Healthcare Provider Details

I. General information

NPI: 1215822853
Provider Name (Legal Business Name): BETHANY ANN RAWLINSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 WILLIAMS DR STE 111
GEORGETOWN TX
78628-3268
US

IV. Provider business mailing address

2423 WILLIAMS DR STE 107
GEORGETOWN TX
78628-3269
US

V. Phone/Fax

Practice location:
  • Phone: 877-800-5722
  • Fax:
Mailing address:
  • Phone: 877-800-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number41527
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: